Discriminating patient care communications system

ABSTRACT

According to the present disclosure, devices, systems, and methods for locating, tracking, and conducting communications between care devices and networks of care facilities through local communications hubs.

CROSS-REFERENCE TO RELATED APPLICATION

The present application is a divisional application of, and claims thebenefit of, U.S. Non-Provisional application Ser. No. 15/498,426, filedon Apr. 26, 2019, which claims the benefit, under 35 U.S.C. § 119(e), ofU.S. Provisional Application No. 62/332,223, filed on May 5, 2016, thecontents of each of which are hereby incorporated by reference in theirentirety.

BACKGROUND

The present disclosure relates to devices, systems, and methods formanaging communications within care facilities. More specifically,devices, systems, and methods for managing communications of patientdevices and networks of care facilities.

Care facilities, such as hospitals, use many types of communications inmanaging patients, staff, and equipment. The increasingly interconnectedenvironments within care facilities present potential formiscommunications but also provide opportunity for increasedcoordination between systems of the care facility. Managingcommunications appropriately can reduce miscommunication and promotecoordination.

SUMMARY

The present application discloses one or more of the features recited inthe appended claims and/or the following features which, alone or in anycombination, may comprise patentable subject matter:

According to an aspect of the present disclosure, a communicationssystem may include devices, systems, and methods for discriminatingcommunications within a care facility, may conduct location monitoringand tracking, and may conduct location-based operations of variousdevices and systems.

According to another aspect of the present disclosure, a patient carecommunications system of a care facility may include a patient bedhaving a bed ID associated therewith. A bed communications device may beattached to the patient bed and may be configured to send and receivebed communications signals. A local communications device may beassociated with a room of the care facility. The local communicationsdevice may be configured to communicate first signals that may have afirst wavelength and that may be configured to communicate secondsignals that may have a second wavelength that may be different than thefirst wavelength. The local communications device may be configured toreceive at least one bed communications signal that may indicate the bedID of the patient bed and to send a confirmation signal indicating thebed ID.

In some embodiments, the confirmation signal may include the firstsignals. The confirmation signal may include an infrared signal, forexample. In some embodiments, the second signals may include one of aBluetooth signal and a Wi-Fi signal.

In some embodiments, the bed communications device may be configured toreceive the confirmation signal that may indicate the bed ID from thelocal communications device and to establish an ad-hoc personal areanetwork with the local communications device in response to adetermination that the bed ID indicated by the confirmation signalcorresponds to the patient bed.

In some embodiments, the ad-hoc personal area network may be a piconet.In some embodiments, the local communication device may be configured tocommunicate with a network of the care facility.

In some embodiments, the ad-hoc network may provide a communicationslink for communication between the bed communications device and thenetwork of the care facility.

In some embodiments, the bed communication device may prevent formationof an ad-hoc network with the local communications device if noconfirmation signal is received.

According to another aspect of the present disclosure patient carecommunications system of a care facility may include a patient bedhaving a bed ID associated therewith and a bed communications devicethat may be attached to the patient bed. The bed communications devicemay be configured to communicate at least one first signal that may havea first wavelength and may be configured to communicate at least onesecond signal that may have a second wavelength different than the firstwavelength. A local communications device may be associated with a roomof the care facility. The local communications device may be configuredfor communication with the bed communications device. In response toreceiving at least one confirmation signal indicating the bed ID, thebed communications device may form an ad-hoc network with the localcommunications device.

In some embodiments, the at least one confirmation signal may includethe at least one first signal. The at least one first signal may includean infrared signal.

In some embodiments, the bed communications device may communicate thebed ID to the local communications device through a bed communicationssignal that may comprise the at least one second signal.

In some embodiments, the ad-hoc network may be a piconet that mayinclude Bluetooth singals.

In some embodiments, the local communication device may be configured tocommunicate with a network of the care facility.

In some embodiments, the ad-hoc network may provide a communicationslink between the bed communications device and the network of the carefacility.

In some embodiments, the patient care communications system may includea second patient bed that may have a second bed ID and a second bedcommunications device that may be attached to the second patient bed. Inresponse to receiving at least one confirmation signal indicating thesecond bed ID, the second bed communications device may form an ad-hocnetwork with the local communications device.

In some embodiments, the local communications device may send the atleast one confirmation signal indicating the second bed ID in responseto receiving the second bed ID from the second bed communicationsdevice.

According to another aspect of the present disclosure, a patient carecommunications system of a care facility may include a patient bed, abed communications device that may be attached to the patient bed, and alocal communications device that may be associated with a room of thecare facility. The local communications device may be configured tocommunicate at least one infrared signal that may indicate an ID code.The bed communications device may receive the at least one infraredsignal and may form an ad-hoc network with the local communicationsdevice by sending a confirmation signal indicating the ID code.

In some embodiments, the confirmation signal may be one of Bluetooth andWi-Fi.

According to another aspect of the present disclosure, a patient carecommunications system of a care facility may include a patient bed and abed communications device that may be attached to the patient bed. Thebed communications device may be configured to communicate at least oneinfrared signal that may indicate an ID code. A local communicationsdevice may be associated with a room of the care facility. The localcommunications device may receive the at least one infrared signal andmay form an ad-hoc network with the bed communications device by sendinga confirmation signal indicating the ID code.

In some embodiments, the confirmation signal may be one of Bluetooth andWi-Fi.

According to another aspect of the present disclosure, a method ofestablishing local communications between a patient support device and alocal communications device may include sending a first signal from afirst device that may indicate ID information, sending a second signalfrom a second device that may indicate ID information, determiningwhether the ID information of the first signal corresponds to the IDinformation of the second signal, and in response to a determination ofcorrespondence, establishing an ad-hoc network between the first andsecond devices.

In some embodiments, the ad-hoc network may be a piconet that mayinclude a Bluetooth transmission.

According to another aspect of the present disclosure, a patient carecommunications system of a care facility may include a patient bed, abed communications device that may be attached to the patient bed, and alocal communications device that may be associated with a room of thecare facility and that may be configured for communication with the bedcommunications device. At least one of the local communications deviceand the bed communications device may transmit at least one ID signalindicating an ID code and may form an ad-hoc network with the other ofthe local communications device and the bed communications device uponreceiving a confirmation signal indicating the ID code.

In some embodiments, one of the ID signal and the confirmation signalmay include a wavelength that is insufficient to communicate throughwalls of the care facility and the other of the ID signal and theconfirmation signal may include a wavelength that is sufficient tocommunicate through walls of the care facility.

In some embodiments, one of the ID signal and the confirmation signalmay be an infrared signal and the other of the ID signal and theconfirmation signal may be at least one of a Bluetooth signal and aWi-Fi signal.

According to another aspect of the present disclosure, a discriminatingpatient care communications system for communication with a network of acare facility may include a plurality of communication hubs that eachmay include circuitry that may be configured to send and receivecommunication signals. A signal meter may be configured to measure thestrength of signals received. A number of the plurality of communicationhubs may be arranged in communication with each other. At least onenetwork hub of the plurality of communication hubs may be arranged incommunication with the network of the care facility. A patient bed mayinclude communication circuitry that may be configured to send signalsthat may indicate bed information to at least one of the plurality ofcommunication hubs.

The system may further include at least one patient care device forattending a patient that may be assigned to the patent bed. The at leastone patient care device may include communication circuitry that may beconfigured to send signals that may indicate care device information toat least one of the plurality of communication hubs. The plurality ofcommunication hubs may be configured to determine a preferred hub of theplurality of communication hubs for communication with the at least onepatient care device based on the greatest signal strength as measured bythe signal meter and may be configured to selectively operate thepreferred hub to receive the signals that may indicate care deviceinformation from the at least one patient care device. The plurality ofcommunication hubs may also be configured to communicate an indicationof the care device information to the network through the at least onenetwork hub and to selectively operate the communication hubs, otherthan the preferred hub, to disregard the signals indicating care deviceinformation.

According to another aspect of the present disclosure, a patient carecommunications system of a care facility that may have a facilitycommunications system may include a patient-care device that may includeat least one audio speaker, a patient-care communications device thatmay be attached to the patient-care device, and a local communicationsdevice that may be associated with a room of the care facility and thatmay be configured for communication with the facility communicationssystem and the patient-care communications device to communicateinformation therebetween. In some embodiments, one of the localcommunications device and the patient-care communications device mayform an ad-hoc network with the other of the local communications deviceand the patient-care communications device. In some embodiments, thelocal communication device may be configured to prioritize audio signalscommunicated from the facility communications system.

In some embodiments, the audio speaker may be configured to provideaudio for one or more entertainment devices associated with the room ofthe care facility. In some embodiments, prioritizing audio signals mayinclude stopping audio play from the speaker provided from the one ormore entertainment devices in favor of audio from the facilitycommunications system.

According to another aspect of the present disclosure, a patient carecommunications system for communication with a network of a carefacility may include a plurality of communications hubs that may includeat least one communications hub that may be arranged within a room ofthe care facility that may be equipped with a preferred nurse callcommunications system. At least two communications hubs may be arrangedwithin a room of the care facility equipped with a non-preferred nursecall communications system. A number of patient care devices may eachinclude communication circuitry that may be configured to communicatesignals to at least one of the plurality of communication hubs. In someembodiments, a first of the at least two communications hubs may bearranged within a room of the care facility that may be equipped with anon-preferred nurse call communications system and that may be incommunication with the non-preferred nurse call communications system.In some embodiments, a second of the at least two communications hubsmay be in communication with the network of the care facility.

In some embodiments, the first of the at least two communications hubsmay communicate with the network through the second of the at least twocommunications hubs. In some embodiments, the second of the at least twocommunications hubs may communicate with the non-preferred nurse callcommunications system through the first of the at least twocommunications hubs.

According to another aspect of the present disclosure, a patient carecommunications system for communication with a network of a carefacility may include a plurality of communications hubs that may includeat least two communications hubs that may be arranged within a room ofthe care facility that may be equipped with a non-preferred nurse callcommunications system. A number of patient care devices may each includecommunication circuitry that may be configured to communicate signals toat least one of the plurality of communication hubs. A first of the atleast two communications hubs may be arranged within a room of the carefacility that may be equipped with a non-preferred nurse callcommunications system and may be in communication with the non-preferrednurse call communications system. A second of the at least twocommunications hubs may be in communication with the network of the carefacility.

In some embodiments, the first of the at least two communications hubsmay communicate with the network through the second of the at least twocommunications hubs. In some embodiments, the second of the at least twocommunications hubs may communicate with the non-preferred nurse callcommunications system through the first of the at least twocommunications hubs.

Additional features alone or in combination with any other feature(s),including those listed above and those listed in the claims and thosedescribed in detail below, may comprise patentable subject matter.Others will become apparent to those skilled in the art uponconsideration of the following detailed description of illustrativeembodiments exemplifying the best mode of carrying out the invention aspresently perceived.

BRIEF DESCRIPTION OF THE DRAWINGS

The detailed description particularly refers to the accompanying figuresin which:

FIG. 1 is a diagrammatic plan view of patient rooms of a care facilityshowing an illustrative embodiment of a patient care communicationssystem providing communications between patient beds each having a bedcommunications device and a network of the care facility through localcommunications devices upon establishing ad-hoc networks;

FIG. 2 is an diagrammatic view of one of the local communicationsdevices in communication with one of the bed communications devices ofFIG. 1;

FIG. 3 is a process flow diagram of an illustrative operation of theestablishing an ad-hoc network;

FIG. 4 is a perspective view of another illustrative embodiment of apatient care communications system providing communications betweenpatient devices and a network of the care facility throughcommunications hubs;

FIG. 5 is a perspective view of one of the communications hubs of FIG.4;

FIG. 6 is a diagrammatic view of the patient care communications systemof FIG. 4 showing that communications hubs include communicationscircuitry for communication with various patient devices using a varietyof signal types and/or protocols;

FIG. 7 is a diagrammatic view of the patient care communications systemof FIGS. 4-6 showing that the system can optionally include a gatewayfor conducting local decision operations;

FIG. 8 is an illustrative depiction of the patient care communicationssystem of FIGS. 4-7 primarily at the software level;

FIG. 9 is a plan view of an arrangement of communications hubs of thepatient care communications system of FIGS. 4-8 showing that thecommunication hubs are in wireless communications with each other toform a mesh network;

FIG. 10 is a plan view of the arrangement of communications hubs of FIG.9 showing that the communications hubs determine a preferredcommunications hub for communications with a patient device based on thereceived signal strength indication;

FIG. 11A is front elevation view of another illustrative embodiment of acommunications hub of the patient care communications system of FIGS. 4and 6-10;

FIG. 11B is a side elevation view of the communications hub of FIG. 11A;

FIG. 12A is a rear elevation view of the communications hub of FIGS. 11Aand 11B;

FIG. 12B is rear elevation view of the communications hub of FIGS. 11A,11B, and 12A including a rear panel cover secured thereto;

FIG. 12C is a top plan view of the communications hub of FIGS. 11A-12B;

FIG. 13 is an exemplary block diagram shows signal connectivity forvarious connections of the communications hub of FIGS. 11A-12C;

FIG. 14 is an exemplary circuit schematic of the communications hub ofFIGS. 11A-13; and

FIG. 15 is exemplary block diagram of the board level of variouscommunications, control, power, and entertainment lines of thecommunications hub of FIGS. 11A-14;

FIG. 16 is a diagrammatic arrangement of a number of communications hubsconfigured for use in a room of a care facility which is not equippedwith a preferred nurse call system;

FIG. 17 is a diagrammatic arrangement of a number of communications hubsconfigured for use in a room of a care facility which is not equippedwith a particular nurse call system, in conjunction with another room ofthe care facility which is equipped with the particular nurse callsystem; and

FIG. 18 is an exemplary circuit schematic of an audio routingconfiguration of the communications hub.

DETAILED DESCRIPTION OF THE DRAWINGS

Information sharing within care facilities, such as hospitals, isincreasingly important to patient care. Care facilities increasingly usewireless communications to facilitate information sharing. Within agiven area of a care facility, multiple communication signals may existsuch that the potential arises for miscommunication between the sourcesand intended receivers of communication signals.

Wireless communication signals often have different effective ranges,whether long- or short-range, that can be configured to decrease thepotential for miscommunication between sources and receivers. Forexample, a short-range communication source signal can reliably inhibitmistaken communications with a receiver that is outside the effectivebroadcast range of that source signal. However, care facilities areoften arranged such that signal sources and receivers are separated bywalls, but not by large distances. Thus, range-limited miscommunicationcontrol can provide incomplete protection against miscommunication.Moreover, such range-limited miscommunication control presents practicaldifficulties in installation, calibration, verification, andmodification, among others. The present disclosure includes devices,systems, and methods for reliably establishing wireless communicationssuch that communications within the intended area are authorized(acknowledged) and communications outside the intended area are denied(disregarded).

An illustrative embodiment of a patient care communications system 10 ofa care facility is shown in FIG. 1. The patient care communicationssystem 10 illustratively includes a patient support deviceillustratively embodied as a patient bed 12, a bed communications device14 attached to the bed 12, and a local communications device 16 incommunication with a network 300 of the care facility. As discussedbelow, the bed communications device 14 and the local communicationsdevice 16 can communicate to form an ad-hoc network through which thebed communications device 14 can communicate information with thenetwork 300.

An exemplary bed 12 is embodied as bed 112A in communication withexemplary local communications device 116A, each located within a room100. The room 100 illustratively shares a wall 115 with another room200. The room 200 illustratively includes another exemplary bed 12embodied as bed 212A that is in communication with another exemplarylocal communications device 216A. As illustratively shown in FIG. 1, thelocal communications device 216A is within the broadcast range 118A ofthe bed communications device 114A despite being located withindifferent rooms 100, 200 and separated by the wall 115. A potential formiscommunication exists between the beds 112A, 212A and their respectivelocal communications devices 116A, 216A due to their close proximity anddespite separation by the wall 115.

However, in the illustrative embodiment, ad-hoc networks are formedbetween the beds 12 and their respective local communications devices 16only upon successful determination of correspondence using infraredsignals. Because infrared signals are generally ineffective tocommunicate through walls, requiring correspondence through infraredsignals before establishing ad-hoc networks can assist in distinguishingbetween specific signal sources and receivers.

In the illustrative embodiment, the local communications device 116A isassociated with room 100. The local communications device 116A isillustratively mounted to the wall within the room 100 near to thelocation at which the bed 112A is positioned and within the effectiverange 118A of the bed communications device 114A. The localcommunications device 116A illustratively receives a unique bedidentification code (bed ID_(112A)) from the bed 112A.

In the illustrative embodiment, the bed communications device 14illustratively communicates a first signal (embodied to include aBluetooth signal) indicating the bed ID₁₂. The local communicationsdevice 16 illustratively receives the first signal and communicates asecond signal as a confirmation signal (embodied to include an infraredsignal) indicating the bed ID₁₂ according to the received first signal.The bed 12 illustratively receives the confirmation signal anddetermines whether the first and second signals include correspondingbed IDs. The bed 12 can thus confirm correspondence between the bed IDsof the first signal and the correspondence signal to identify whetherthe local communications device 16 is within the same room as the bed12. Upon determination of successful correspondence, the bed 12 forms anad-hoc network with the local communications device 16, illustrativelyusing Bluetooth low energy communications. In some embodiments, thead-hoc network may include any suitable signal type and/or protocol.

With reference to the specific exemplary components in FIG. 1, theexemplary bed 112A illustratively communicates and confirmscorrespondence with the exemplary local communications device 116A toform an ad-hoc network therewith. The exemplary bed communicationsdevice 114A illustratively communicates a first signal (embodied toinclude a Bluetooth signal) indicating the bed ID_(112A). The localcommunications device 116A illustratively receives the first signal andcommunicates a second signal as a confirmation signal (embodied toinclude an infrared signal) indicating the bed ID_(112A) as indicated bythe received first signal. The bed communication device 114Aillustratively receives the confirmation signal and determinescorrespondence of the received bed ID_(112A). The bed 112A can thusconfirm correspondence between the bed IDs indicated by the first signaland the correspondence signal to identify whether the localcommunications device 116A is within the same room as the bed 112A. Upondetermination of successful correspondence, the bed communicationsdevice 114A forms an ad-hoc network with the local communications device116A, illustratively using Bluetooth low energy communications.

In comparison, the local communications device 216A can receive thefirst signal indicating the bed ID_(112A) from the bed 112A, but itsinfrared confirmation signal cannot effectively communicatecorrespondence through the wall 115 to confirm correspondence to the bed112A. The local communications device 216A is illustratively positionedwithin the broadcast range 118A such that it can receive the firstsignal indicating the bed ID_(112A) from the bed 112A. The localcommunications device 216A communicates a second signal as aconfirmation signal (embodied as an infrared signal) indicating the bedID_(112A). However, because the confirmation signal is an infraredsignal, it cannot effectively communicate through the wall 115 and thusbed 112A does not effectively receive the confirmation signal from thelocal communications device 216A. Moreover, the bed 212A isillustratively within range of the confirmation signal, but has its ownunique bed ID_(212A) and thus does not form an ad-hoc network with thelocal communications device 216A based on a non-corresponding bedID_(112A). As suggested in FIG. 1, when local communications device 216Areceives (via Bluetooth) and confirms (via infrared) the bed ID_(212A),the bed 212A illustratively forms an ad-hoc network with localcommunications device 216A.

In the illustrative embodiment as shown in FIG. 2, the bedcommunications device 14 illustratively includes at least one processor20, at least one memory device 22 configured to store instructions forexecution by the processor 20, and communication circuitry 24 configuredto receive and transmit communication signals with other bed systems,for example, a bed controller. The bed communications device 14illustratively includes infrared (IR) communications circuitry 26 andother communications circuitry 28 configured to communicate with thelocal communications device 16.

As shown in FIG. 2, the local communications device 16 includes at leastone processor 30, at least one memory device 32 configured to storeinstructions for execution by the processor 30, and networkcommunications circuitry 34 configured to exchange (receive andtransmit) communication signals with network 300. The localcommunications device 16 illustratively includes infrared (IR)communications circuitry 36 and other communications circuitry 38configured to communicate with the bed communications device 14.

As shown in FIG. 3, a process flow diagram illustratively includes steps40-48. The process steps 40-48 are described in terms of theillustrative embodiment of the patient care communications system 10,discussed above, but its description can apply to any of thearrangements and/or embodiments disclosed, whether expressly orimplicitly, herein.

In step 42, a first signal is communicated indicating identifyinginformation. The first signal is illustrative transmitted from a firstdevice (embodied as the bed communications device 14) to a second device(embodied as the local communications device 16). The first signal isillustratively embodied as a Bluetooth signal indicating the bed ID. Instep 42 of the illustrative process flow diagram, the first signal isillustratively transmitted at regular intervals. Optionally, the processmay include step 40 in which the second device first sends a promptsignal to the first device to prompt sending of the first signal. Aftersending the first signal in step 42, the process proceeds to step 44.

In step 44, the second signal is transmitted indicating the identifyinginformation according to the first signal. The second deviceillustratively transmits a second signal as a confirmation signalindicating the bed ID according to the first signal. In the illustrativeembodiment, the confirmation signal is embodied as an IR signalindicating the bed ID according to the first signal. The processproceeds to step 46.

In step 46, correspondence is determined between the identifyinginformation of the first signal and the second signal. The first deviceillustratively determines whether the identifying information of thesecond signal corresponds to the identifying information of the firstsignal. In the illustrative embodiment, the first device determineswhether the bed ID indicated by the second signal corresponds to the bedID indicated by the first signal. If the identifying information of thesecond signal does not correspond to the identifying information of thesecond signal, the process returns to step 42. If the identifyinginformation of the second signal does correspond to the identifyinginformation of the second signal, the process proceeds to step 48.

In step 48, an ad-hoc network is established between the first andsecond devices. The first device illustratively permits formation of anad-hoc network with the second device. In the illustrative embodiment,the bed communications device 14 permits formation of an ad-hoc networkwith the local communications device 16.

In the illustrative embodiment, IR signals are only communicated in asignal direction, from the local communications device 16 to the bedcommunications device 14. The bed communications devices 14 isillustratively configured to receive, but not to transmit IR signals.The IR communications circuitry 26 is illustratively embodied to includecircuitry for receiving but not transmitting, IR signals. By requiringonly circuitry for receiving IR signals on the bed communications device14 the complexity and expense of the bed hardware and the power demandfor bed communications can be reduced. In the illustrative embodiment,the local communications device 16 is configured to transmit and receiveIR signals, but in some embodiments, may be configured only to transmitIR signals to minimize cost and complexity. In some embodiments, one orboth of the local communications device 16 and the bed communicationsdevice 14 may include IR transmitters and IR receivers.

In the illustrative embodiment, the bed 12 communicates a first signal,embodied to include a Bluetooth signal, indicating the bed ID, and thelocal communications device 16 responds with a second signal, embodiedto include an infrared signal indicating the bed ID as indicated by thefirst signal. In some embodiments, the local communications device 16may be configured to prompt the bed 12 for the first signal, forexample, by first sending a prompt signal embodied as an IR promptsignal. In some embodiments, the bed 12 may communicate the bed ID asthe first signal as described above. In some embodiments, the IR promptsignal may indicate a unique identifier corresponding to the localcommunications device 16 and the bed 12 may receive the IR prompt signaland send a response signal, embodied as a Bluetooth signal, indicatingthe received unique identifier. The local communications device 16 mayreceive the response signal and form an ad-hoc network with the bed 12upon confirmation that the received unique identifier corresponds to thesent unique identifier. In some embodiments, the prompt signal may be aBluetooth signal and the response signal may be an IR signal.

In the illustrative embodiment, the bed 12 sends the first signalembodied as a Bluetooth signal and the local communications deviceresponds with the second signal embodied as an IR signal. In someembodiments, the first signal may include an IR signal indicating thebed ID and the local communications device 16 receives the first signaland sends the second signal as a Bluetooth signal indicating thereceived bed ID to the bed 12 for confirmation of correspondence andformation of an ad-hoc network upon confirmation. In some embodiments,including those mentioned immediately above, the IR signals are onlycommunicated in a signal direction, between the local communicationsdevice 16 to the bed communications device 14 and the communicationscircuitry 26, 36 of the respective bed communications device 14 andlocal communications device 16 may be correspondingly limited inarrangement to only transmit or receive IR signals as described.

In some embodiments, the bed communications device 14 may be embodied asa patient communications device mounted to or included in any patientcare device, such as a patient lift, pump, vital signs monitor (e.g.,EKG, ECG, EEG, respiration rate monitor, blood pressure monitor, pulseoximetry equipment), etc. and multiple patient communications devicesmay communicate with the local communications device to establish anad-hoc network. In some embodiments, upon successfully establishing anad-hoc network between multiple patient communications devices and thesame local communications device 16, the local communications device 16responsively configures the patient communications devices for directcommunication with each other (when capably equipped, for example, whenconfigured for communication with the same protocol).

Returning to FIG. 1, the network 300 illustratively includes variousfacility communications intercommunicated devices and processes, forexample, medical records database (MMR) 310, communications circuitry312 in communication with local communications devices 16, servers 316,local workstations 314, and workflow databases 318. In the illustrativeembodiment, the workflow databases 318 are embodied to include at leastone relational database for storing, maintaining, and accessing uniqueidentification codes assigned to staff, equipment, locations, and otherthings of the facility in correspondence with each other. In theillustrative embodiment, the local communications device 116A isassociated with room 100 by association within the relational databaseof the network 300, but may be directly associated by programming and/orother suitable methods.

As mentioned above, upon formation of an ad-hoc network between a bed 12and a local communications device 16, the local communications device 16provides communication between the network 300 and the bed 12. The bed12 can communicate with the network 300 through the local communicationsdevice 16 to send and receive information therebetween. Communicationsmade through local communications device 16 illustratively indicate anID code unique to the specific local communications device 16 that isillustratively maintained with association by the network 300.

Another illustrative embodiment of a patient care communications system1000 for communication with the network 300 of the care facility isshown in FIG. 4. The patient care communications system 1000 is similarto the patient care communications system 10 and the disclosure of thepatient care communications system 10 applies to the patient carecommunications system 1000, except in instances of conflict with thedescription of the patient care communications system 1000 below. Thepatient care communications system 1000 illustratively includescommunication hubs (generally 1010, collectively 1010, and individually1010A, 1010B) in communication with each other and with a number ofpatient devices 1012, 1014, 1016 arranged to communicate informationwith the communications hubs 1010. The patient devices 1012, 1014, 1016,sometimes referred to herein as patient care devices, can communicateinformation with the network 300 through the communications hubs 1010while discriminating against certain communications, for example, basedon relative location. Discriminating certain communications can enablefine location determination of the patent devices 1012, 1014, 1016and/or adaptive connectivity between the network 300 and patient devicesincluding those that use different communications platforms and/orprotocols.

In the illustrative embodiment as shown in FIG. 4, the communicationshubs 1010 are shown as being stationary within the care facility,illustratively located within sections A, B of the patient room 101.Patient room 101 is illustratively embodied as a shared patient room,and the sections A, B each indicate distinct areas of the room 101 thatare generally considered exclusive to one of a pair of patients assignedto the shared room 101. Such rooms are sometimes referred to assemi-private rooms. The patient devices 1012, 1014 are illustrativelylocated within section A and are associated with section A of the sharedroom 101, and the patient device 1016 is illustratively located withinsection B and is associated with section B of the shared room 101. Eachcommunications hub 1010 is configured to be mounted to a wall of room101 at a location corresponding to its respective section A, B.

In the illustrative embodiment, each communications hub 1010A, 1010Bcommunicates with the patient devices 1012, 1014, 1016 that are locatedwithin their respective section A, B and discriminate againstcommunication with devices that are not within their respective sectionA, B. The communications hubs 1010 themselves illustratively define thesections A, B in some embodiments. In the illustrative embodiment, thecommunications hubs 1010A, 1010B are in communication with each other todetermine a preferred hub of the communications hubs 1010 for eachpatient device 1012, 1014, 1016.

In the illustrative embodiment shown in FIG. 4, the communications hubs1010A, 1010B determine which among them is a preferred communicationshub for each patient device 1012, 1014, 1016 based on their receivedsignal strength from each patient device 1012, 1014, 1016 as explainedin detail below. Although each communications hub 1010A, 1010B is withinsignal range of each patient device 1012, 1014, 1016, the patient device1016 communicates device information with hub 1010B as its preferred hub(as indicated by the respective double line communications link 1015between device 1016 and hub 1010B in FIG. 4), while being disregarded byhub 1010A; and the patient devices 1012, 1014 each communicate deviceinformation with hub 1010A as their preferred hub (as indicated by therespective double line communications link 1015 between devices 1012,1014 and hub 1010A in FIG. 4), while being disregarded by hub 1010B.Each patient device 1012, 1014, 1016 illustratively communicates withthe network 300 through its respective preferred hub, although the hub1010B illustratively communicates with the network 300 through the hub1010A as discussed below. In some embodiments, the hub 1010B may be incommunication with the network 300 without communicating through the hub1010A.

In the illustrative embodiment of FIG. 5, the communications hubs 1010are configured to send and/or receive various types of signals forcommunication with the network 300 and the patient devices 1012, 1014,1016. The communications hubs 1010 illustratively include a housing 1018having various hardwired communication circuitry 1020 such as hardwiredports (e.g., parallel ports including standard 37 pin connections usedin HILL-ROM® nurse call systems, serial ports, coaxials, universalserial bus (USB), SPI, I2C, UART, fiber optics, ethernet, other generalpin input/output (GPIO), other analogue and/or digital ports, etc.) andvarious wireless communications circuitry 1022 for wirelesscommunications (e.g., Bluetooth®, Zigbee®, Wi-Fi®, WiMAX, 3G and/or 4Gtechnology, radio frequency (RF), infrared (IR), sonar, includingdifferent versions thereof (e.g., classic Bluetooth® and Bluetooth4.0/low energy), and/or other wireless and/or mobile communicationssignal types and/or protocols).

In the illustrative embodiment, the communications hubs 1010 cancommunicate with the patient devices 1012, 1014, 1016 using any of thecommunications circuitry 1020, 1022 (including any of the their variousports, wired and/or wireless signals types, and/or wired and/or wirelessprotocols) to enable communications across diverse communicationplatforms of different patient devices 1012, 1014, 1016. For example, ifthe patient device 1012, embodied as a patient bed, is only enabled forWi-Fi communications while the patient device 1014, embodied as apatient lift, is only enabled for Bluetooth communications, thecommunications hubs 1010 can communicate information with both patientdevices 1012, 1014 in their respective connections (i.e., wirelessprotocols in this example). In another example the patent bed 1012 maybe connected to one of the communications hubs 1010 by parallel orserial wired connection to a port while the lift 1014 is only enabledfor Bluetooth communications, and the one communications hub 1010 canstill communicate information with both patient devices 1012, 1014through the respective wired and wireless connections.

In the illustrative embodiment as shown in FIG. 6, the communicationshubs 1010 each illustratively include a processor 1024, a memory device1026 storing instructions for retrieval and execution on the processor1024, and communications circuitry 1028, 1030 for communicatinginformation between the processor 1024 and other devices. The memorydevice 1026 illustratively includes protocol stack(s) for providing atransport interface for communications between the patient devices 1012,1014 and the network 300 (i.e., transport between the device protocoland the network protocol). In the illustrative embodiment as shown inFIG. 6, the communications circuitry 1028, 1030 each send and receivesignals as directed by the processor 1024 to provide the transportinterface between the network 300 and the patient devices 1012, 1014.

The communications hubs 1010 illustratively receive signals indicatingdevice information from the patient devices 1012, 1014, 1016 using theirrespective base protocols. The communications hubs 1010 illustrativelyimplement the appropriate protocol stack to provide the transportinterface for communications between the patient devices 1012, 1014,1016 and the network 300 as needed. In the illustrative embodiment, thecommunications hubs 1010 include protocol stacks to accommodate each ofthe variety of base protocols through which the patient devices 1012,1014, 1016 communicate.

In the illustrative embodiment, the communications hubs 1010 provide thetransport interface between the network 300 and the patient devices1012, 1014, 1016 that have any mode of wireless and/or wiredcommunication. The communications hubs 1010 illustratively provide atransport interface for communication between the patient devices 1012,1014, 1016 themselves, for example, between the exemplary Wi-Fi ofpatient bed 1012 and the exemplary Bluetooth of patient lift 1014. Insome embodiments, upon successful connection of multiple patient devices1012, 1014, 1016 to the same communications hub 1010, the communicationshub 1010 responsively configures those patient devices 1012, 1014, 1016connected to the same hub 1010 for direct communication with each otherwhen capably equipped (for example, a bed 1012, and lift 1014 both insection A and communicating with hub 1010A are configured to exchangeinformation directly as indicated by arrows 1017 in FIG. 4, and the bed1012 may for example communicate a patient weight as measured by a loadscale of the bed 1012 to the lift 1014 for appropriate configuration),for example, when configured for communication with the same protocol.The communications hubs 1010 illustratively provide a transportinterface between patient devices having different preferred hubs, forexample, between the patient device 1016 and the patient devices 1012,1014.

In some embodiments, the communications hubs 1010 may use a number ofcombined protocols (without an intermediary or transport protocol) tocommunicate information directly between the network 300 and eachpatient device 1012, 1014, and/or between the patient devices 1012,1014, 1016 themselves, according to their base protocols. Thecommunications hubs 1010 thus provide a common communications platformusing the underlying communications capability of each device, andwithout requiring upgrading, replacement, and or customization of thesoftware of each device 1012, 1014, 1016.

As show in FIG. 6, the wireless communications circuitry 1022 of eachcommunications hub 1010 illustratively includes various interfacecircuitry 1022 a, 1022 b, . . . 1022 i, that each are configured toaccommodate different wireless signal types and/or protocols. Theinterface circuitry 1022 a, 1022 b, 1022 i are illustratively embodiedto independently include communications components such as antennas,receivers, transmitters, and/or signal conditioners (e.g., filters,amplifiers, converters, isolaters, etc.), but in some embodiments mayshare any number of components. By example, the patient bed 1012illustratively communicates only in Wi-Fi and sends and receives Wi-Fisignals with Wi-Fi interface circuitry 1022 a, and patient lift 1014illustratively communicates only in Bluetooth and sends and receivesBluetooth signals with Bluetooth interface circuitry 1022 b. Theprocessor 1024 performs the appropriate protocol transport for theinformation received by the communications circuitry 1020, 1022 andsends signals according to the output protocol to the network 300 viathe communications circuitry 1028 and/or to the appropriate patientdevice 1012, 1014 via the communications circuitry 1020, 1022.

In the illustrative embodiment as shown in FIG. 6, the communicationshubs 1010A, 1010B each communicate with the network 300. Thecommunications hub 1010A communicates with the network 300 viacommunications link 1015, while communications hub 1010B illustrativelycommunicates with the network 300 through the communications hub 1010A.The communications circuitry 1030 illustratively sends and receivessignals as directed by the processor 1024 with the communicationcircuitry 1030 of the communications hub 1010B.

In the illustrative embodiment, the communications hubs 1010A, 1010Bcommunicate with each other via the network protocol. In someembodiments, the preferred hub of each patient device 1012, 1014, 1016performs protocol transport for communications with its respectivedevice, and/or the communications hub 1010A, 1010B that is sendingcommunications to the other hub 1010A, 1010B determines the applicableprotocol for communication between the hubs 1010, for example, to reducemultiple transport, the hub 1010A may send communications from thepatient bed 1012 to the communications hub 1010A using the base protocolof the patient bed 1012. In some embodiments, the manner of protocoltransport for each transmission scenario (considering e.g., whetherto/from a patient device or the network 300, the patient device type,device location, communication protocol, information/communication type)may be partly or wholly predetermined and/or dynamically determined bythe communications hubs 1010. In some embodiments, the communicationshub 1010B may include its own communications circuitry 1028 (as shown indashed line in FIG. 6) for communication with the network 300.

As shown in FIG. 6, the patient devices 1012, 1014, 1016 eachillustratively include an operations module 1032 includingcommunications circuitry 1034 for communicating with the communicationshubs 1010, a processor 1036 for executing instructions stored on amemory device 1038, and device components 1040 for performing variousdevice functions (e.g., sensors, actuators, pumps, fans, etc.). Theprocessor 1036 of each patient device 1012, 1014, 1016 is illustrativelyembodiment as a main processor that controls each of device operationand communications. In some embodiments, device operation andcommunication may be performed by any number of hardware and/or softwarecomponents that are partly and/or wholly shared.

Referring to FIG. 7, the patient care communications system 1000 canoptionally include a gateway 1050 for providing localized decisionsupport. In the illustrative embodiment, the gateway 1050 is arrangedbetween the communications hubs 1010 and the network 300 and performs avariety of evaluation and decision functions for communications andoperations support. The gateway 1050 illustratively conductscommunications with each of the network 300 and the communications hubs1010.

In the illustrative embodiment, the gateway 1050 performs localizeddecision support based on communications from each of the network 300and the communications hubs 1010. In a network-driven example, thegateway 1050 can illustratively implement localized decision operationsaccording to direction from the network 300. The gateway 1050illustratively receives room commands from the network 300 indicating adesired room configuration for a particular patient, for example, a“fall risk” room configuration for a patient characterized as a fallrisk. The gateway 1050 illustratively receives the desired roomconfiguration (“fall risk”) command from the network 300, determines thespecific device configurations required to achieve the desired roomconfigurations, and communicates device commands to the communicationshubs 1010 indicating the specific device configurations. Thecommunications hubs 1010 communicate the specific device configurationsto each patient device 1012, 1014, 1016 according to its communicationsstandards as discussed above.

Continuing with the fall risk example mentioned above with reference toFIG. 7, a computer device on the network 300 illustratively issues a“fall risk” room command to the gateway 1050 in response to one or moreuser inputs, such as at a remote computer or station (e.g., EMRcomputer, master nurse station, ADT computer, etc.). In response to the“fall risk” room command, the gateway 1050 illustratively determinesthat the appropriate “fall risk” room configuration requires devicecommands that configure the patient bed 1012 to require a patient lift1014 to be present (e.g., within in the same section A, B as the patientbed 1012) when bed side rails are lowered or else a fall alarm shall beissued. The gateway 1050 communicates the device commands to thecommunications hub 1010 for communication to the patient bed 1012. Inthis example, the communications hub 1010 illustratively determines thepresence of the patient lift 1014 (e.g., within in the same section A, Bas the patient bed 1012) according to whether the bed lift 1014communicates with the communications hub 1010 as its preferred hub asmentioned above and discussed in detail below. Thus, the communicationshub 1010 itself can implement certain device commands as appropriate.The gateway 1050 illustratively conducts localized decision operationsusing network-room level communications.

In a room-driven example, the gateway 1050 can conduct localizeddecision operations based on patient device information. The gateway1050 illustratively receives device information from any of the patientdevices 1012, 1014, 1016. For example, the gateway 1050 illustrativelyreceives communication from the patient bed 1012 that a patient isoccupying the bed and that a bed side rail is in a lowered position(e.g., indicating that the patient occupying the patient bed 1012 mayintend to exit the bed). Following the above “fall risk” example, thegateway 1050 illustrative issues a command for local alarm (e.g.,illuminate attention indicator light on patient bed 1012) in response tothe indication that the bed side rail is lowered, but does notcommunicate with the network 300 to issue an system alarm requiringcaregiver attention (e.g., nurse call) because the gateway 1050 receivesindication from the patient lift 1014 that it is located within therelevant proximity of the patient bed 1012 (illustratively, withinsection A). The gateway 1050 illustratively conducts localized decisionoperations using room level communications.

In some embodiments, the communications hubs 1010 may be incommunication with various devices such as telemetry devices, windowshades, television, temperature/humidity control, room lighting, etc.and may operate the various devices to predetermined configurations upondetection of event scenarios such as a patient bed entering the room100, detection of a patient, etc. For example, upon entrance of apatient into the room 100, the communications hubs 1010 may operate thelighting in the room for a default moderate light setting.

In the illustrative embodiment, a single gateway 1050 conducts localizeddecision operations for a single communications hub 1010, but in someembodiments, one or more gateways 1050 may provide local decisionoperations for one or more communications hubs 1010, for example, asingle gateway 1050 may conduct localized decision operations for eachroom of the care facility including for all communications hubs 1010therein. In some embodiments, the gateway 1050 may be combined inhardware and/or software components with one or more communications hubs1010.

The patient devices 1012, 1014, 1016 have been illustratively describedas respective patient beds, patient lifts, and patient fluid pumps, butin some embodiments may include any number and/or type of patientdevices such as vital signs monitors, exercise equipment, passive motionmachines, etc. As shown in FIG. 7, the system 1000 illustrativelyincludes another patient device embodied as a wireless communicationsdevice 1041 in communication with the communications hubs 1010. Thewireless communications device 1041 includes a wireless speakerconfigured to play audio received from the communications hubs 1010 fromthe network 300 (for example, voice communications over a nurse callsystem) and/or from an in-room television, and a nurse call button forcommunicating a call to the network 300 for transmission over a nursecall system. In the illustrative embodiment, the wireless communicationsdevice 1041 communicates with the communications hubs 1010 usingBluetooth low energy communications, but in some embodiments maycommunicate with the communications hub 1010 by any suitable mannerDevice 1041 is sometimes referred to as a pillow speaker.

In the illustrative embodiment, the wireless communications device 1041includes a solar cell for converting light energy into electrical powerand a battery for storing power from the solar cell for use by thewireless communications device 1041, but in some embodiments may includea battery charging system. The system 1000 illustratively includes anumber of dedicated wireless nurse call switches 1043 (for example, nearthe bath, shower, and/or bedside) in communication with thecommunications hubs 1010 and each having a solar cell and battery fordedicated nurse call function. In some embodiments, the communicationshubs 1010 may periodically confirm connectivity with the wirelesscommunications device 1041 and/or the nurse call switches 1043 toprovide continual communications availability. In some embodiments, thewireless communications device 1041 may include a microphone andcircuitry for audio transmission from the patient to the network 300 toallow voice communications with caregivers.

As shown in FIG. 7, the system 1000 illustratively includes anotherpatient device embodied as a display device 1042 for display ofinformation related to the patient, the room, the patient devices, etc.In the illustrative embodiment, the display device 1042 is a tabletcomputer, but in some embodiments may be any suitable graphical displaydevice and/or graphical user interface. The display device 1042illustratively communicates with each of the network 300 and the otherpatient devices 1012, 1014, 1016, 1041 through the communications hubs1010.

The display device 1042 illustratively receives information from thenetwork and/or other patient devices 1012, 1014, 1016, 1041 through thecommunications hubs 1010 and provides graphical display and interfacefor user interaction as suggested in FIG. 7. For example, deviceinformation such as device operating parameters for the patient bed 1012are illustratively presented in graphical form on the display device1042 and a caregiver can illustratively operate the display device 1042to change the firmness of an inflatable mattress of the patient bed1012, can observe the weight of a patient occupying the patient bed 1012as measured by the bed's load scale system, and/or observe battery powerlevels of the patient devices 1012, 1014, 1016, 1041.

In some embodiments, the display device 1042 may be configured todisplay and/or operate other patient devices that are in communicationwith the communications hubs 1010 such as telemetry devices, windowshades, television, temperature/humidity control, room lighting, etc. Inthe illustrative embodiment, the display device 1042 is operable toprovide full device functionality control of the patient devices, but insome embodiments, may provide limited functionality control. In someembodiments, the display device 1042 may be accessible only tocaregivers and not to patients and/or visitors, for example, bypasscode, and/or may have limited controls for non-caregivers.

The display device 1042 illustratively receives and displays informationfrom the network 300 as suggested in FIG. 7. For example, the displaydevice 300 may receive patient identification information such as dateof birth, gender, medical records, laboratory results for display and/ormanipulation through the communications hubs 1010. The display device1042 illustratively displays the number and location information ofpatient devices within the room and communicating with thecommunications hubs 1010. The display device 1030 illustratively permitsconfiguration of the communications hubs 1010 (and/or the gateway 1050when included), for example, manual assignment of patient devices tocommunicate with one of the communications hubs 1010A, 1010B as thepreferred hub. In the illustrative embodiment, the display device 1042is permanently located within room 100, but in some embodiments, may belocated at a nurse station and/or be portable throughout the carefacility. In some embodiments, the display device 1042 may beconnectible to the communications hubs 1010 by a cable forcommunications therewith. In some embodiments, the display device 1042and/or the wireless communications device 1041 may communicate with thegateway 1050 and/or the network 300 directly.

As shown in FIG. 8, an illustrative depiction of the system 1000 isshown primarily at the software level. In the illustrative embodiment,the network 300 includes a hospital interface which communicates withvarious systems through middleware. The middleware is illustrativelyimplemented between the network 300 function and the gateway 1050functions (and/or communications hubs 1010 in embodiments that do notinclude the gateway 1050). Additional display device applications 1052communicate with network 300 through the middleware to generally provideconsistent graphical user interface formats, systems, and/or stylesand/or consistent programming interfaces, database, security,configuration, reporting, notification, rules, logic, etc. In theillustrative embodiment, particular software implementation may beconducive to certain articulated structural arrangements describedherein, but in some embodiments, software and/or hardware may bearranged in any suitable manner, and/or according to the particularneeds of the care facility.

As mentioned above, the patient care communications system 1000 isillustratively arranged for local network communication betweencommunications hubs 1010 including device locating, such as real timelocating as shown in FIGS. 9 and 10. Referring to FIG. 9, a plurality ofcommunications hubs (generally 1010, collectively 1010, and individually1010 ₁₋₉) are shown from overhead in various states of communicationwith each other. Each communications hub 1010 is illustratively incommunication with those other communications hubs 1010 based onproximity, as indicated by the labeled circles around the hubs 1010.

For example, as shown in FIG. 9, the communications hub 1010 ₁ isillustratively near to and is in communication with each of hubs 1010 ₂,1010 ₄, 1010 ₅ as indicated by the labeled circles 2, 4, 5 surroundingthe hub 1010 ₁. Comparably, the communications hub 1010 ₂ isillustratively near to and is in communication with each of hubs 1010 ₁,1010 ₃, 1010 ₆, 1010 ₅, 1010 ₄ as indicated by the labeled circles 1, 3,6, 5, 4, surrounding the hub 1010 ₂. Comparably, the communications hub1010 ₅ is illustratively near to and in communication with each of hubs1010 ₁, 1010 ₂, 1010 ₃, 1010 ₆, 1010 ₄, 1010 ₇, 1010 ₉, 1010 ₈ asindicated by the labeled circles 1, 2, 3, 6, 4, 7, 9, 8 surrounding thehub 1010 ₅. In the illustrative embodiment, the communications hubs 1010can form a mesh topology, but in some embodiments may include any of ahub-and-spoke, star, ring, token ring, bus, and/or tree topology. In theillustrative embodiment as shown in FIG. 9, the communications hubs 1010are arranged in a square framework (shown from overhead). Thearrangement of the communications hubs 1010 is illustrative and in someembodiments, the communications hubs 1010 may be arranged in anysuitable manner relative to each other.

In the illustrative embodiment shown in FIG. 9, only communications hub1010 ₇ is in direct communication with the network 300, and all otherhubs 1010 _(1-6, 8, 9) communicate with the network 300 through the hub1010 ₇. Each communications hub 1010 is illustratively in communicationwith hub 1010 ₇ either directly and/or indirectly through other hubs1010. For example, the hub 1010 ₈ is in direct communication with thehub 1010 ₇ as illustrated by the numbered ring 7 around the hub 1010 ₈.Hub 1010 ₃ is illustratively in indirect communication with hub 1010 ₇through any number of connections, for example, through hub 1010 ₅and/or through hubs 1010 _(2, 4). In the illustrative embodiment, thecommunications hubs 1010 collectively determine the preferredcommunications routing, but in some embodiments communications routingmay be partly or wholly predetermined.

In the illustrative embodiment as shown in FIG. 10, an overhead view ofthe communications hubs 1010 is shown. Each communications hub 1010includes a signal meter 1054 ₁₋₉ configured to measure the strength ofreceived signals. The communications hubs 1010 of FIG. 9 are shownwithout the labeled circles indicating intercommunication. The system1000 illustratively includes another patient device, embodied as alocator tag 1044 carried by a caregiver. The locator tag 1044 isillustratively embodied as a passive RFID tag that receives energy fromRFID signals of the communications hubs and broadcasts a tagidentification code in response, but in some embodiments may communicatewith hubs 1010 by any suitable signal type and/or protocol. The tagidentification code is illustratively associated with a specificcaregiver by the network 300.

Instead of the labeled circles as shown in FIG. 9 indicatingintercommunication between the hubs 1010, in the illustrative embodimentshown in FIG. 10 the certain hubs 1010 _(1, 2, 3, 5) include a signalring 1046 that indicates communication with the locator tag 1044. FIG.10 shows a table 1048 _(1, 2,3,5) next to each of the hubs 1010_(1, 2, 3, 5) that identifies the strength (dB) of the signal receivedby the respective hub 1010 _(1, 2, 3, 5) from the locator tag 1044 asmeasured by the respective signal meter 1054 _(1, 2, 3, 5.) Each hub1010 _(1, 2, 3, 5) illustratively receives a signal from the locator tag1044 and measures the strength of the received signal. Each hub 1010_(1, 2, 3, 5) communicates the strength of its received signal to theother hubs 1010 and collectively the hubs 1010 deem the hub 1010 withthe highest signal strength as the preferred hub for the locator tag1044. In the illustrative embodiment, the preferred hub for locator tag1044 is hub 1010 ₂ that illustratively has a signal strength of −60 dB.

In the illustrative embodiment as shown in FIG. 10, in response to thedetermination of the preferred communications hub 1010, the preferredhub (illustratively 1010 ₂) serves at the endpoint for patient devicecommunication. The preferred hub (illustratively 1010 ₂) configuresitself for direct communication with the locator tag 1044, while theother communications hubs 1010 _(1, 3-9) configure themselves todisregard direct communications from the locator tag 1044. The locatortag 1044 illustratively communicates with any of the communications hubs1010 and the network 300 through the preferred hub (illustratively 1010₂).

In the illustrative embodiment as shown in FIG. 10, the communicationshubs 1010 continually re-designate the preferred hub based on the signalstrength as discussed above. As the locator tag 1044 moves throughoutthe communications hubs 1010 (for example, as a caregiver carryinglocator tag 1044 moves throughout a room of the care facility), thereceived signal strengths for each hub illustratively change withproximity to the locator tags 1044 and the greatest signal strength isdeemed the preferred hub for any location. The preferred hub 1010corresponds to the caregiver's location in the healthcare facility. Insome embodiments, the communications hubs 1010 may periodicallyre-designate the preferred hub, may re-designate the preferred hub onloss of communication between the preferred hub and the locator tag1044, and/or may re-designate the preferred hub upon the received signalstrength by the preferred hub falling below a threshold value.

In the illustrative embodiment as shown in FIG. 10, the system 1000 canaccurately determine and track the location of the locator tag 1044 andtherefore, the location of the caregiver transporting the tag 1044. Inthe illustrative embodiment, the preferred hub illustrativelycommunicates its selection as the preferred hub to the network 300and/or to the gateway 1050 for tracking. In a given patient room,tracking the preferred hub can provide additional resolution as to theplaces in the patient room that the caregiver enters.

As shown in FIG. 10, the system 1000 illustratively includes anotherpatient device embodied as another locator tag 1056. The locator tag1056 is illustratively attached to a caregiver's clothing on thecaregiver's chest and the caregiver is illustratively facing in thevertical direction (as shown in the overhead view in FIG. 10) asindicated by the curvature on the top side of the semi-circle symbol forlocator tag 1056. FIG. 10 shows a table 1052 _(6, 9)next to each of thehubs 1010 _(6,9) that identifies the strength (dB) of the signalreceived by the each hub 1010 _(6, 9) from the locator tag 1056 asmeasured by the respective signal meter 1054 _(6, 9). In theillustrative embodiment, the locator tag 1056 is positioned with equaldistance from each of the communications hubs 1010 ₆, 1010 ₉, but thesignal strength measured by hub 1010 ₉ is greater because thecaregiver's body (illustratively represented by the flat side of thesymbol for locator tag 1056) at least partly impedes direct line ofsight with the communications hub 1010 ₆.

In some embodiments, the communications hubs 1010 may communicate todefine specific areas such as patient bed areas and/or handwashing zonesfor use in event based patient care monitoring. By defining specificzones, the system 1000 can provide a level of automated eventmonitoring, for example, requiring entrance into a handwashing zoneafter exposures to potentially contaminated areas andgenerating/silencing alarms in response to the tracking.

In the illustrative embodiment, the communications links 1015 areembodied as Bluetooth® Low Energy (BLE), but in some embodiments mayinclude any suitable type of wireless communications such as Bluetooth®,Zigbee®, Wi-Fi®, WiMAX, etc., mobile communications technologies such as3G or 4G technology, radio frequency (RF), and or other wireless and/ormobile communications protocols. In some embodiments, the communicationshubs 1010 may periodically confirm connectivity with any wirelessdevices including the patient device to provide continual communicationsavailability.

As shown in FIGS. 11A, 11B, and 12A-12C, another illustrative embodimentof the communications hub 2010 of the system 1000 includes variousconnectivity features. The communications hub 2010 is similar to thecommunications hub 1010 and the disclosure of the communications hub1010 applies to the communications hub 2010 except in instances ofconflict with the description of the communications hub 2010. As shownin FIG. 11A, the communications hub 2010 illustratively includes ahousing 2012 that encloses various components. The housing 2012 includesvarious input and/or output ports 2015 projecting therethrough forconnections with other devices and/or systems. The ports 2015illustratively include a female 37-pin connector 2016 for connectionwith a nurse call cable extending from patient bed 12, a male 37-pin bedconnector 2018 for connection with a third party nurse call system(e.g., pass through), a 20-pin pillow speaker connector 2020 forconnection with a 20-pin pillow speaker, and a ¼ inch jack receiver 2022for connection with ¼ inch jack of a generic alarm cable extending froma respective patient care device, each arranged on a front wall of thehousing 2012. The housing 2012 illustratively includes an IR sensor2024, a nurse call button 2026 (indicated as a cancel button, that canbe depressed to place and to cancel a nurse call request), and amulti-color LED status indicator 2028, also each on the front wall ofhousing 2012. As shown in FIG. 11B, the ports 2015 illustrativelyinclude an HDMI output port 2030, and a pair of USB ports 2032 arrangedon a side wall of the housing 2012. A rear cover 2034 is illustrativelysecured to a rear of the housing 2012 to enclose circuitry withinhousing 2012 and support connectors thereon as discussed below.

As shown in FIG. 12A, the housing 2012 illustratively includes amounting bracket 2036 arranged on the rear side for mounting thecommunications hub 2010 and for receiving rear cover 2034 therethrough.As best shown in FIG. 12A, the housing 2012 illustratively includes anouter shell 2038 that defines an interior housing that receives an innerhousing 2040. The outer shell 2038 illustratively encloses the front,top, bottom and sides of the inner housing 2040 and defines a rearopening 2042. The inner housing 2040 illustratively includes a rearplate 2044 covering the rear opening 2042 of the outer shell 2038 toreceive the mounting bracket 2036 secured thereto.

As shown in FIG. 12A, the mounting bracket 2036 includes an opening 2046defined therethrough to expose rear connections 2048. The rearconnections 2048 include connection ports 2050, 2052, 2054, 2056, 2058,2060, 2062. The connection ports 2050-2060 are each embodied as RJ-45connectors for connection with a Power over Ethernet module (throughport 2050), upstream data connections (through port 2052), downstreamdata connections (through port 2054), next generation room stations(through port 2056), a multi-segment dome light (8-segment, through port2058), and a next generation wall switch (through port 2060). Theconnection port 2062 is embodied as a 14-pin entertainment connector forconnection with entertainment controls, for example, low voltagecontrols for television, radio, and/or room lighting.

As shown in FIG. 12B, the rear cover 2034 includes openings 2064 throughwhich the connection ports 2050-2060 and 2062 can receive cableconnections while the rear cover 2034 is attached with the mountingbracket 2036. As shown in FIG. 12C (having the rear cover 2034 removed),the housing 2012 illustratively includes a micro USB slot 2066 and areset button 2068 arranged on a bottom wall. The communications hub 2010is illustratively adapted to conduct operations as disclosed above usingthe various ports 2015 and connections. In some embodiments, thecommunications hubs 2010 may include any number and/or configuration ofcommunications connections, ports, components, etc for conductingoperations.

Referring to FIG. 13, an exemplary block diagram of the signalconnectivity of the communications hub 2010 is shown. In theillustrative embodiment, the communications hub 2010 includes aboard-to-board connector 2061 which communicates with the nurse callsystem of the network 300. The board-to-board connector 2061 and each ofthe bed connector (e.g., 2016), pillow speaker connector (e.g., 2020),and third party connector (e.g., 2018) illustratively commnuicatethrough a signal buffering module 2065. The IR sensor 2024, jackreceiver 2022, and nurse call button 2026 each illustrativelycommunicate directly with the board-to-board connector 2061. In someembodiments, any number and/or type of signal conditioning modules maybe applied to various board communications.

Referring now to FIG. 14, an exemplary circuit schematic of thecommunications hub 2010 is shown. The communications hub 2010illustratively includes a system on a module (SOM) 2070 communicatingwith other systems and devices as discussed, directly and/or throughvarious power controllers (e.g., power controller 2072, voltageregulators 2074), transmitter/receivers (e.g., transceivers 2076),switches (e.g., Ethernet switch 2078), and/or other signal managementcircuitry for performing communications hub operations. The SOM 2070 isillustratively equipped with a processor (e.g., iMX6, 1 GHz, 512 MB RAM,Audio Codec, 70C, LINUX, 200-pin, storage: 512 MB and/or 8 GB eMMC) withwireless capabilities (e.g, Wi-Fi 802.11 a/b/g/n with MIMO+Bluetooth4.0/BLE). In some embodiments, the SOM 2070 may include an audio storageCODEC and/or any suitable processor and/or component arrangement.

FIG. 15 shows an exemplary board level block diagram of thecommunications hub 2010 including connection of the RJ-45 connectors,power, various communications inputs/outputs, various control lines, andentertainment connections between the communications hub 2010 and thenurse call board, bed, pillow speaker, third party nurse call system,and/or other system and devices, as well as control relays includinginterlock and nurse call relays 2080, entertainment relays 2082 (e.g.,room lights, radio, television), and audio relays 2084. Thecommunications hubs 2010 illustratively include a programmable system ona chip (PSoC) equipped with one or more of built in SPI, UART, I2Cinterfaces, and/or digital and/or analog I/Os, etc.. Although notnecessarily depicted in FIGS. 13-15, in some embodiments, thecommunications hub 2010 may include various circuitry for wirelesscommunications with any of patient devices and/or network 300.

Referring now to FIGS. 16 and 17, exemplary arrangements ofcommunications hubs 2010 within care facilities are shown. The exemplaryarrangement of FIG. 16, represents one suitable implementation ofcommunications hubs 2010 in room(s) of a care facility, the room(s) areillustratively not equipped with a preferred nurse call system such as,for example, the Navicare® Nurse Call (NNC) system marketed by Hill-RomCompany, Inc. of Batesville, Ind. 47006. In the illustrative embodimentof FIG. 16, a number of communications hubs 2010A-D are shown incommunication with respective patient beds 2112A-2112D.

The communications hub 2010A illustratively communicates with thenetwork 300 through a power-over-Ethernet (POE) switch 2088 (shown aspart of network 300, but in some embodiments, may be distinct and incommunication with network 300) as shown in FIG. 16. Communications hubs2010B-2010C are illustratively arranged in communication with thenetwork 300 through the communications hub 2010A via links 2090,embodied as hardwiring. In the illustrative embodiment, thecommunications hubs 2010A, 2010B are connected to communicate with theirrespective beds 2112A, 2112B via hardwired bed links 2092 and thecommunications hubs 2010C, 2010D are illustratively connected tocommunicate with their respective beds 2112C, 2112D via wirelesscommunications links 2094, such as Bluetooth LE 4.0 communications insome embodiments.

The communications hub 2010D is illustratively arranged in communicationwith a third party nurse call system 2096 to conduct nurse callcommunications. The communications hubs 2010A-2010C are illustrativelyarranged in communication with the third party nurse call system 2096through communications hub 2010D. The communications hubs 2010A-2010Dare illustratively located within the same room of the care facility,but in some embodiments may be located in different rooms, for examplebut without limitation, rooms with close proximity and/or sharing walls.Moreover, in some embodiments, each of the individual communicationslinks 2090, 2092, 2094 may be wholly or partly wired and/or wirelesslinks.

Referring now to the exemplary arrangement of FIG. 17, a number ofcommunications hubs 2010E, 2010F are shown in communication withrespective patient beds 2112E, 2112F via wired bed communications link2092 and wireless communications link 2094, respectively. Similar to thearrangement of FIG. 16, the communications hubs 2010E, 2010F are locatedwithin a room 2098 that is illustratively not equipped with a preferrednurse call system. The communications hubs 2010E, 2010F areillustratively arranged in communication with each other and with thenetwork 300 through communication links 2090. The communications hub2010F provides communication with an optional third party nurse callsystem 2096 through the respective communications link 2090, but in someembodiments, the third party nurse call system 2096 may be formed aspart of the network 300 or may be excluded. As will become more clearwith the description below, the optional third party nurse call system2096 may include arrangements in which different portions of the samecare facility may have different legacy nurse call systems. Another room2100 of the care facility is embodied as equipped with the preferredNavicare® Nurse Call (NNC) system.

As shown in FIG. 17, the room 2100 illustratively includes Audio StationBed Connectors (ASBC) 2102 in communication with one or more graphicalroom stations (GRS) 2104 which can include graphical user interfaces forinteraction with patients and/or staff and located within the room 2100.Also associated with the room 2100 is a dome light 2105 (located in ahallway near a door to room 2100) and a nurse call switch 2106 withinthe room 2100. Each of the ASBC, 2102, GRS 2104, dome light 2105, andnurse call switch 2106 is illustratively arranged in communication witha room control board 2108. The room control board 2108 is illustrativelyembodied as a dedicated device for each room equipped with the preferrednurse call system providing communication with the network 300. AnotherGRS 2110 is illustratively arranged at a master nurse station but suchstations may be fixed and/or portable and/or located at other staffworkstations for communications with the network 300, patient beds 2112,and/or other devices and systems.

In the exemplary arrangement of FIG. 17, each of the non-NNC equippedroom 2098 and the NNC-equipped room 2100 communicate with the network300 through the POE switch 2088. Accordingly, non-NNC equipped rooms andthe NNC-equipped rooms of the same facility can each communicate withthe hospital network 300 and with each other as needed. As suggested inFIG. 17, various room devices, including the GRS 2104 (including theASBC's 2102 via the GRS 2104), dome lights 2105, and switches 2106,individually connect with the room control board 2108 to communicatewith the network 300 and GRS 2110 with a multi-level architecture. Incomparison, the communications hubs 2010 enable bed-centriccommunications/control/monitoring of various room devices and systems incommunication with the network 300 and/or third party nurse call systems2096, with room-localized networking.

Referring now to FIG. 18, an exemplary audio routing arrangement of thecommunications hub 2010 is shown. Hub 2010 is labeled as “UniversalCollector” in FIG. 18 to indicate the hub's ability to receive data froma variety of different patient devices. The communications hub 2010 isillustratively arranged to route audio for each of the dome light 2114,the bed 2112, and the pillow speaker 2116. The communications hub 2010illustratively receives microphone inputs 2118 (e.g., sample line levelanalog signals) from each of the pillow speaker 2116 and the bed 2112and communicates audio signals between the bed 2112, the pillow speaker2116, and various devices (e.g., television, radio, nurse call, etc.).The communications hub 2010 illustratively includes various audiocircuitry (e.g., amplifiers, gain controllers, etc.) for conditioningaudio signals and speaker relays 2120 for operating each of the bed 2112and the pillow speaker 2116 for audio communication, including inaccordance with their respective volume control levels.

As may or may not be indicated within the figures, the presentdisclosure includes one or more communications hubs, which may bereferred to as Universal Collectors, and may be adapted for use with theNNC system. In some embodiments, each communications hub can be adaptedto provide power to room-level devices and systems such as room stations(e.g., standard or graphical), light stations (e.g., segmented domelight), and/or other communications hubs. The communications hubs, whenconnected to a patient bed via Bluetooth and/or other wireless link canbe operated as an audio station bed connector, network interface unit,and/or bed sidecom. The communications hubs can be arranged to muteentertainment audio, upon and/or during communication of a preferredcommunication, for example, a staff and/or patient communication. Thecommunications hubs can be arranged to communicate audio wirelessly to apatient bed, for example, by Bluetooth, from any of the devicesconnected with its 14-pin entertainment connector, connected roomstations, and/or from its third party 37-pin nurse call connector. Thecommunications hubs can be arranged to communicate entertainment controlsignals received from a patient bed to its 14-pin connector tocommunicate with devices such as televisions, lighting, climate control,and/or other room controls. The communications hubs can be arranged todetect connection of a patient bed with its 37 pin connector.

The present disclosure includes devices, systems, and methods forlocation determination, tracking, and utilization such that when anobject or person with an emitter walks through a mesh of receivers, thereceivers within range will query all peers whether they see thatparticular emitter, and if so, the signal strength; each of the peerdevices repeat the previous operation until the emitter is no longerobserved; eventually all receivers will have a table of signal strengthsfor the emitter and it peers. The receiver that has the strongest signalcan then, with a relative high level of confidence, know that it is theclosest receiver to the emitter.

The present disclosure includes descriptions of the use of fixedlocation receivers configured in a mesh topology by a discovery process.When an emitter (object) moves within the mesh of RF receivers, thesystem is able to automatically associate the emitter to the nearestreceiver. This can be used with algorithms (e.g. signal strengthweighted moving average) to improve the confidence of the emitterlocation. When a receiver is activated it looks for any other receiversthat are within its range and connects to them either wirelessly orwired. This will form a mesh of connected receivers that are connectedto each other. Using a simple grid of receivers in which each device canonly see others immediately next to them determines how the mesh is tobe formed.

The present disclosure includes descriptions of a room gateway forlocalized decision support as well as accepting information from abroader system. The Room Gateway may be embodied as a computing devicethat provides acquisition and manipulation of data from providers in theroom. Data providers can include devices (beds, lifts, pumps, etc.) aswell as any other component in the room that generates data. Devicesphysically connect via a device interface that can package the data intoa format that can be understood by the Gateway. The device interfaceimplements the physical (e.g. Bluetooth, WiFi, RS485) connection as wella protocol stack that can package the device data into a format that canprocessed by the gateway. The Gateway can be configured with multipleprotocol handlers that will enable it to act on data from multipledevice types.

Data received from the devices can include the following: a data pointcan be combined with one or more data points from other devices to helpin decision support Immediate results can then be sent to other devicesas an actionable event to caregivers or patients; consolidated data isalso sent to a server (e.g. EMR, HIS, etc.) for further processing andanalysis; device status is an event that represents the health andcurrent operational state of the device; consolidated status is alsosent to the server (e.g. EMR, HIS, etc.) for further processing andanalysis; and a command message can be used to initiate interactionsbetween two devices that have different protocols. Data received fromthe server can include the following: patient and caregiver informationcan be forwarded on to the devices to configure them for the particularneeds of the patient or staff; workflow instructions to automaterepetitive tasks; and events that require staff or patient attention.The Gateway may be one of several processing tiers. Each tier is able toprovide functionality even if its parents are not available. If theGateway loses communication with the server it can still service all thedevices in the room as well as provide intermediate storage forprocessed data until the server is available again. An example ofmultiple tiers may include Server (Data storage and analysis, extendeddecision support); Room Gateway (Device data aggregation, eventprocessing, localized decision support); Device Interface (Devicecommunication, data packaging); and Device (Data source).

The present disclosure includes leveraging existing communicationsframework for real time location systems (RTLS) to exchange data betweendevices and to associate devices to a location and/or a patient. Thecommunication framework may be leveraged to establish connectivity andassociations between devices and locations for exchanging and gatheringof data. For example, by capturing device data from a device (e.g., beddata from a bed) using a Wi-Fi connection (or other wireless connection)of a locating component (RTLS/Wi-Fi locator badge) used to associate thedevice (bed) with the location; and upon recognition that anotherpatient device (e.g., a patient lift) is also discovered and associatedwith the same location using a locating (RTLS/Wi-Fi locator badge), thedevices (e.g., lift and bed) can communicate with each other. In someembodiments, the device may communicate over the locating Wi-Ficonnection to exchange data. Such arrangement may be used to raise orlower a bed for lift height to assist patient and caregiver when movinga patient and/or capture weight of patient seamlessly. Automated deviceassociation promotes interconnectivity and information sharing.

The present disclosure includes devices, systems, and methods fordynamic locating by taking into account patterns as well as historicaldata to determine person or object location. This allows for preciselocating that adapts to changes in the environment. For example, in anarraignment having three locating receivers (nodes) equidistant fromeach other (and for example at 0 degrees, 120 degrees, and 240 degreesfrom the subject person and/or object), a staff member with a locatingtransmitter facing node 1 would receive a higher signal strength thanother nodes. The system may record locator transmitter information aseach node and combine multiple data points (beyond simple geometries)over time based off nodes within a given area (e.g., a room) to makebetter assessment of person and/or object location.

The present disclosure includes descriptions of location trackingincluding consideration of a locator tag's velocity, acceleration,rotation, positioning, and/or combinations thereof. The locator tagillustratively include various sensors that may be embodied as any ofaccelerometers, gyroscopes, and/or compasses, to communicateacceleration, orientation, and/or positioning data for use indetermining the location of the locator tag. The system may applydynamic weighting of the accuracy of these variables to determinelocation with accuracy. A locator tag may communicate the data to areceiver, which may optionally measure signal strength. The receivercommunicates the data (and optionally the signal strength) to a centralcomputing device that determines location of the locator tag based onthe data (and optionally the signal strength), historical information,and/or predictive determination.

Although certain illustrative embodiments have been referenced withinthis disclosure, variations and modifications exist within the scope andspirit of this disclosure as described and as defined in the claimsbelow.

1. A patient care communications system for communication with a networkof a care facility, the system comprising: a plurality of communicationshubs including at least one communications hub arranged within a room ofthe care facility equipped with a preferred nurse call communicationssystem and at least two communications hub arranged within a room of thecare facility equipped with a non-preferred nurse call communicationssystem, and a number of patient care devices each includingcommunication circuitry configured to communicate signals to at leastone of the plurality of communication hubs, wherein a first of the atleast two communications hubs arranged within a room of the carefacility equipped with a non-preferred nurse call communications systemis in communication with the non-preferred nurse call communicationssystem and a second of the at least two communications hubs is incommunication with the network of the care facility.
 2. The patient carecommunications system of claim 1, wherein the first of the at least twocommunications hubs communicates with the network through the second ofthe at least two communications hubs.
 3. The patient care communicationssystem of claim 1, wherein the second of the at least two communicationshubs communicates with the non-preferred nurse call communicationssystem through the first of the at least two communications hubs.
 4. Apatient care communications system for communication with a network of acare facility, the system comprising: a plurality of communications hubsincluding at least two communications hubs arranged within a room of thecare facility equipped with a non-preferred nurse call communicationssystem, and a number of patient care devices each includingcommunication circuitry configured to communicate signals to at leastone of the plurality of communication hubs, wherein a first of the atleast two communications hubs arranged within a room of the carefacility equipped with a non-preferred nurse call communications systemis in communication with the non-preferred nurse call communicationssystem and a second of the at least two communications hubs is incommunication with the network of the care facility.
 5. The patient carecommunications system of claim 4, wherein the first of the at least twocommunications hubs communicates with the network through the second ofthe at least two communications hubs.
 6. The patient care communicationssystem of claim 4, wherein the second of the at least two communicationshubs communicates with the non-preferred nurse call communicationssystem through the first of the at least two communications hubs.
 7. Thepatient care communication system of claim 4, wherein the at least twocommunications hubs includes at least three communications hubs.
 8. Thepatient care communication system of claim 7, wherein at least one ofthe at least three communications hubs is arranged to communicate withthe non-preferred nurse call communications system through the first ofthe at least two communications hubs.
 9. The patient care communicationsystem of claim 8, wherein the second communications hub is arranged tocommunicate with the non-preferred nurse call communications systemthrough the first communications hub.
 10. The patient care communicationsystem of claim 9, wherein the second communications hub is arranged tocommunicate with the first communications hub through an intermediaryone of the at least three communications hubs.
 11. The patient carecommunication system of claim 10, wherein the intermediary one of the atleast three communications hubs is arranged to communicate with thenon-preferred nurse call communications system only indirectly throughthe first communications hub.
 12. The patient care communication systemof claim 7, wherein at least one of the at least three communicationshubs is arranged to communicate with the network of the care facilitythrough the second of the at least two communications hubs.
 13. Thepatient care communication system of claim 12, wherein the firstcommunications hub is arranged to communicate with the network of thecare facility through the second communications hub.
 14. The patientcare communication system of claim 13, wherein the first communicationshub is arranged to communicate with the second communications hubthrough an intermediary one of the at least three communications hubs.15. The patient care communication system of claim 14, wherein theintermediary one of the at least three communications hubs is arrangedto communicate with the network of the care facility only indirectlythrough the second communications hub.
 16. The patient carecommunications system of claim 4, wherein at least one of the pluralityof communication hubs is configured to communicate wireles sly with atleast one of the number of patient care devices.
 17. The patient carecommunications system of claim 11, wherein at least one of the pluralityof communication hubs is configured to communicate wireles sly with atleast one of the number of patient care devices via bluetooth.
 18. Thepatient care communication system of claim 4, wherein at least one ofthe patient care devices is a patient bed.
 19. The patient carecommunication system of claim 2, wherein the at least two communicationshub includes at least three communications hubs, and the firstcommunications hub communicates with the second communications hubthrough an intermediary one of the at least three communications hubs.20. The patient care communication system of claim 19, wherein theintermediary one of the at least three communications hubs is arrangedto communicate with the network of the care facility only indirectlythrough the second communications hub.
 21. The patient carecommunication system of claim 3, wherein the at least two communicationshub includes at least three communications hubs, and the secondcommunications hub communicates with the first communications hubthrough an intermediary one of the at least three communications hubs.(New) The patient care communication system of claim 21, wherein theintermediary one of the at least three communications hubs is arrangedto communicate with the non-preferred nurse call communications systemonly indirectly through the first communications hub.
 23. The patientcare communication system of claim 1, wherein at least one of thepatient care devices is a patient bed.